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31C-054 (5) 49 FORD CROSSING BP-2019-1081 GIS#: COMMONWEALTH OF MASSACHUSETTS Mgp:Block:31C-054 CITY OF NORTHAMPTON Lot: -21 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Cateforv:REPAIR BUILDING PERMIT Permit# BP-2019-1081 Project# JS-2019-001764 Est.Cost:$32500.00 Fen:$211.25 PERMISSIONIS HEREBY GRANTED TO. Const.Class: Contractor: License: Use Gmun: KENT PECOY & SONS CONSTRUCTION INC 052589 Lot Size(w.ft.): Owner. KENT PECOY&SONS CONSTRUCTION INC zonine: Applicant KENT PECOY & SONS CONSTRUCTION INC AT: 49 FORD CROSSING Apolicant Address: Phone. Insurance: 215 BALDWIN ST (413) 781-7008 WC WEST SPRINGFIELDMA01089 ISSUED ON:4/38019 0:00:00 TO PERFORM THE FOLLOWING WORK FLOOR JOIST REPLACEMENT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeTYpe: Date Paid: Amount: Building 4/3/20190:00:00 $211.25 212 Main Street,Phone(413)587.1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File N BP-2019.1081 APPLICANT/CONTACT PERSON KENT PECOY At SONS CONSTRUCTION INC ADDRESS/PHONE 215 BALDWIN ST WEST SPRINGFIELD (413)781.7008 PROPERTY LOCATION 49 FORD CROSSING MAP 31C PARCEL 054 21 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSE UIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tvueof Construction: FLOOR JOIST REPLACEMENT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 052589 3 sets of Plans/Plot Plan THE FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: _Approved_Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER:§ Finding Special Permit Variance- Received& ariance•Received.$Recorded at Registry of Deeds Proof Enclosed _Other Permits Required: Curb Cm from DPW Water Availability Sewer Availability _Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay `l-3-Zoj9 Signature of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. •Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. Department use only City of Northampton Status of Perms: _ Building Department Curb Cut/Dnveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northamp MA 01060 Two Sets of Structural Plans phone 413-587-1 4D F LR 0 ite Plans D Oth Specify APPLICATION TO CONSTRUCT, LTE ,R ,RENOVATE O DEM LISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION PT OF 1.1 PfeOerlV AdAddress: DUILDIN i PISPECTI This Wdon to be completed by once NORTHq�,q+rDN ,AAef ONa 3/G Lot OSS Unit 49 Ford Crossing, Northampton, MA 01060 zone Overlay District Elm St District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Kent Pecoy& Sons Construction,Inc. 215 Baldwin Street,West Springfield,MA 01089 Name(Print) Current Mailing Address: 413-304-3879 Teephons Signature 2.2 Authorized Agent: AAci ip,auek wet+so wP,aa H4ald N e(Print) Current Mailing Address: �P 41�- >0 4-3874 Sign t�reSign tures Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Coat(Dollars)to be Official Use Only completed by rmit applicant 1. Building 4/ 32 tr00 (a)Building Permit Fee 2. Electrical SI (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Pemlil Fee d. Mechanical(HVAC) 5.Fire Protection 6. Total=(I -2 s3+4+5) Cheri Number This Section For Official Use Only Building Permit Numb c DateIssued: Signature: Building Commissioner/Inspector or Buildings Data EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed.Permit Can Be Denim Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in lh' Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage % (Iss aro minus bldg A paved parlinjo #of Parking Spaces Fill: volume it axa —_. ---. A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book . Page and/or Document it B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO Oi IF YES, describe size, type and location: E. Will the construction activity disturb(deanng,grading,excavation,at filling)over 1 acre or is it part of a common plan that will disturb over lam? YES O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alterations) Q Roofing ❑ Or Doom ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [0 Siding(0] Other[01 Brief Description of Proposed Floor joist replacement Work: Alteration of existing bedroom___Yes x No Adding new bedroom Yes x No Attached Narrative Renovating unfinished basement Yes x No Plans Attached Roll -Sheet Sa. If New house and or addition to existing housing complete the following. a. Use of building:One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? I. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction I. Is construction within 100 ft.of wetlands?_Yes No. Is construction within 100 yr, floodplain_Yes_No j. Depth of basement or cellar floor below finished grade Is. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank_ CitySewir Private well_ City water Supply_ SECTION Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, k O `I �1 `♦ as Owner of the subject properly 11 hereby authorize KP44;- ? co4 Er5O-.5 "kvGtfon to act on my behalf, in all matters relative to work authorized by this building permit application. Signature M(ovner Data Z Q I, I.O �' �t (0�-1 ,as Owner/Authorized Agent hereby dedare that statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Prim Name Signature of Ownuahkgent Data SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Constnictlon Supervisor: Not Applicable ❑ Name of License Hamer: Kent W. Pecoy License Number 215 Baldwin Street, West Springfield, MA 01089 CS-052589 Add... Expiration Date 413-304-3879 09/16/2019 Signatures moi Telephone 9 Realstered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number Ken-Ir Pecoj & So,$ Cpn4 ,.r io^ 107367 Address Expiration Data '2-IS63e�dWi-. 5-� hks4-5f,&,, iAfbtA-otO69Telephone `t13 3o4-3879 07/30/2020 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(8)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... Jill No...... ❑ City of Northampton Massachusetts i J�c4 rSPANlOanrT OF BUILDING ZNSP=ZONS 212 Iain Strut • mnici"l Building aorthBmpton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair,modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-exisang owneroccupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:ff the homeowner has contracted with a corporation or LLC,that entity must be registered. Type of Work: r]-e- Tec-} 211 iac& Ie,T Est.Cost:k$ 37-1500 _ Address of Work: T 1 r ,v, 0 Date of Permit Application: 3/29/2019 I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _lob under$1,000.00 _Owner obtaining own permit(explain): _Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.C.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: 3 2019 ^IeGoN & Sons Lo t+rte lro l07 ?L7 Dae Con[mct Name HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: 3/'29hol9 -� Dae Owner Name and Signature i City of Northampton Massachusetts � � r i 1'{ 4; 212 Min S ee BUILDING IN ilding f9 212 Main rCi p •Municipal auiltling aT+ � MpcNaapton, NA 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: 49 Fo,d doss, No, ti� n1A oro6C' (Please print house num and street name) Is to be disposed of at: S SAak oh 2d- M //i dsoi CT- 06088 (Please print name and location of facir Or will be disposed of in a dumpster onsite rented or leased from: USA' r-r'aV rine 655 oLan R . Fsi LnJsO6o80 (Company N and Address) KLS��014 Signature of Permit Applicant or Owner D to If, for any reason, the debris will not be disposed of as indicated,the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts Department of Industrial Accidents Wlytwkers' 1 Congress Street,Suite 100 Boston,MA 02114-2017www.mass.gov/dia Compensation Insurance Affidavit:Builders/Contractors/Electricions/Plumbers. TO BE FILED WITH THE PERMITTING At'THORITY. Aoolieant Information Please Print Leeibly Name(Businces/OrgsnientioNlndlvidua0l Kent Pecoy 8 Sons Construction, Inc. Address: 215 Baldwin Street City/State/Zip: West Springfield,MA01089 Phone#: 413.781-7008 Arc you an employee Check the appmpdate hoz: Type of project(required): LQlamaemployerwith 20 employees(full undbr pen-tine)• 7. []New construction 2.❑Iemasole pmprimm or parmenM1ip and have tw employea working formein 8. ❑Remodeling any cnW.V.(No workers comp mauniree required.] 3❑I am a homeowner doing all work myself [No workers'compinsurance required]t 9. ❑Demolition 4.❑l am a homeowner and willbe hiringcontractors m conduct all work on 10❑Building addition ensy property. 1 will care that all contractors either have workers mmpensnion imurance cram sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5C]lama general contractor sureptd I vorea it haw,wontrac Co.rs ,murs.: eM1W sheer 13❑Roofrepair5 Theca subsontracton have employees and have workers compimumteet &[:]We art is mrpomaon and its.Years have csemittd their fight ofexcmytion per MGL c. 14.❑J Other Floor Joist Repair 152,§I(4Z and m have no employee¢.[No workers'comp Insurance nyuired.] "Ary applicant that checks box at must also fill out the section helow showing their workers'compensation polity information. I Nomeonmem who subminhis turtwit Indicating they are doing all work and then hire outside contractors must submit anew andevit indicating such. :Cmuract ¢that check this box most attached madditional sheet showing the name ofthe sul.couracmrs and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'camp.pou,number. 1 am an employer thalis providing workers'compensation insurancefor rap employees. Below is the policy and job site information. Insurance Company Name: Borawski Insurance Policy#or Self-ins,Lic.#: WMZ8008006823 Expiration Date: 08/30/2019 Job Site Address: 49 Ford Crossing City/State/yip:NorthamptonMA 01080 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage in required under MGL c. 152,§25A is a criminal violation punishable by a fine up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may he forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify un/deer tthhe pains and penalties ofinerjury that the information provided above Is true and correct. Signature: Date: �Z,Q 2o I er Phone#? 413-304-3879 Official use only. Do not write in this area,to be completed by city or town offrcfal. City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector b.Other Contact Person: Phone#: ACORO® CERTIFICATE OF LIABILITY INSURANCE DA's'"MmmYY.YI 00130/2010 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANP. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the tames and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the cedi icaus holder in lieu of such endoraement(s). PRODUCER NAuME, "N a BBl as Bora%Rkl ensu RIFOR lw. ENI (113)5065011FNP%Mn: (013)58&]8]3 80 King Street,Suile Bnooses® oaliseiQboraArsklinsurencecam LFFOROWDO IMAGE NAIL/ NotlM1empbn MA 01/)80.329 INEURENA. Netherlands Insurance 2<1T1 INSURED URERa Paedees Insurance Company Kent Pea,8 Sone CongnRflon,enc INSURER, AIM Mutual 215 Beldon St maueee D: PURERE: West Springfield MA 01088 NPARERF' COVERAGES CERTIFICATE NUMBER: 71111619All Ones REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF MY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO MICH THIS CERTIFICATE AMY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MY HPA BEEN REDUCED BY PAID CLAIMS. INER L1R I'Heme NRANCE PoLICYNUMBER MMIDD'Y'Y MW LICYIDD'YYYPMY LINnI X GDMMERCULDEKRALL...TY RRFNCE i 1.0001000 cl.e MOE ®OCCUR 3 1W'DCO n m 1 5.OW A CBP87WS56 07JD112018 07/012018 ADVIIM PY 3 1,000.000 GEN'LAOGREWTE LIMITAPPUES PER GRENME 3 21000,00 PoLICV®jEi ®LOC PRODUCTS-COMPIOPAGG 3 2,000,000 O ER: AUTOMOBILE LJ ABILITY INGLEUNIT y 1000,000 NIVAUTO RY/Per Rif S A OANED X SOHEouLEO BA8781OW CTAH2010 07MIQ019 a ,YN,,uRYlP..R.) E AUTOS ONLY ANOMCLL HUTOR INED ONLY X AUTOSONLV Po ewJen GAMAGE 3 3 UMBREWWe OLGIR EACH OCCURRENCE 8 5,000000 B EXCEe3 LUB CINMBIMDE CUS78MI 0710112018 0]/012018 AGGREGATE 3 5,000,000 OED X REIENTON a 10000 3 WORNERBCOMPENSATON PER OTH- AND R NPLLOYENe'UADILIm TAT ER C ANY ETOILPARTNEEXECI IVE YO NIA VeMZB00B00B823 OBI302010 081302019 EL EACN ACGDENT s `"00.000 inCERMFMDER EXCL& MWFbn In Nig E.L.DISEASE-EA EMPLOYEE 3 51)0.001) It Yee.aeuw,rAx 500,000 DESCRI%ION OFOPERATIONS Na- EL DIREASE-POLICY LIMIT 3 eCAPTON OF OPEMTIONSI LOGTONB I YFMCLEB(ACORD tot.Ards(Ru RemeMe eaayuY,nuY bM<Ne soca.spew le III Floor 3ois$ ty1i ti.t.l} � Ford C�Dssn-J �br#t r LP b 1Ma olcGo CERTIFICATE HOLDER / CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN CA,Of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 125 Locust Street AUMORQED REPRERENTATVE NoMemptan MAW A 01080 � ' 01888--L200155 ACORD CORPORATION. All rights reamed. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ®( C.-ro salts of Massachusetts 7 DNIMon of PrOtesslonal Licensure 804M of Building ftegulefions and Slandards Construction Supervisor CS D62669 4pires:09/16/2019 KENT W PECOY 216 BBLIWIIM3rT WEST SPRINDFELD MR OtOBp'�l Commissloiner C4 Construction Supervisor Unrestricted.Buildings of any use group which contain kss than 36,000 cubic feet(991 cubic meters)of enclosed Si Failure to possess a current edition of Me Massachusstte Slate Building Coda is cause for revocMion of thu license. For Intamulic n abed this ftcn Call(617)7274200 or visit www.rnass.90vldpt J- wo," � Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration < . Typtr corporation KENT PECOY d SONS CONST.INC. ' �? Registration: 107387 215 BALDWIN ST Expiration: 07/30/2020 WEST SPRINGFIELD,MA 01089 y, ' Update Address and Return Card, Orl rI WE IMPROVEMENT TCONTaRpulatlan only NOMEIMPgOV;Co,p CONTRACTOR Registration valid for ate. dual Iffouneetur TYPE:CarooraEx SWnra theonsupp r data. nPoutsiness to: Registration 073=020 Oflit1000 Washington Save Business Regulation 10]30] 0]I]02020 1000 Weahinel0n sa0W�Suita 710 KENT PECOY B SONS CONST.INC. Boation,MA 02118 KENT W.PECOY 215 8ALDW IN ST WEST SPRINGFIELD,MA 01088 Undersecretary IO Valid without signature Single TJIe Common Joist—Structural Composite Lumber(SCL)Replacement Step 1:Add new SCL next to TJI•Joist with Flak Jacket® Glue top aM sloe of the top of Ne new SCL and Ideal It tight against the subfloor and exlabng TIN w/Flak Jacket'. No finished Mooring(not Shown): Use U (0.131"x 2.5')®12"o.c.from Sheathing above roto top of SCL. With finished flooring(shown):Use 60 x 2'...on nails®12"o.c.,has nailed,to Secure to the wb%oor. Details am conceptual.Consult w10 design professional of record to ensure proper design and Installation. Step 2: Connect and remove TJI®joist with Flak Jacket" Y. Fasten the new SCL Joist to the top Flange of the Se ding T31s w/Flak Jacket protection with 160 pneumatic nada(0.131"x 3')at 12'o/c. Remove bottom flange and web of existing TJIe Joist w/Flak JackdO,leaving top flange In place. Bottom surface of top flange Is permitted to be removed by planing or other means provided that a minimum of 1 Y"thickness Is left iMstt. flocking(shown)is optional and may be considered where subfloor deflection Is deemed critical(i.e.subflwr panel Joints,the finished Flooring,etc.)